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Luo Y, Cai B, Li B, Liu F, Du L, Zhao D, Fan W, Meng L, Zhang X, Ma L. The Acute Toxicities and Efficacy of Concurrent Chemotherapy With Docetaxel Plus Cisplatin, or Docetaxel, or Cisplatin and Helical Tomotherapy in Patients With Locoregionally Advanced Nasopharyngeal Carcinoma: A Randomized Single-Center Phase II Trial. Technol Cancer Res Treat 2022; 21:15330338221109974. [PMID: 35770295 PMCID: PMC9251964 DOI: 10.1177/15330338221109974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022] Open
Abstract
Objective: The objective of this trial is to evaluate and compare the acute toxicity in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) treated with docetaxel plus cisplatin, or docetaxel, or cisplatin concurrently with helical tomotherapy during concurrent chemoradiotherapy (CCRT). Methods: In a prospective, single-center, open-label, randomized phase II study, after 2 cycles of induction chemotherapy with docetaxel plus cisplatin regimen, 125 patients with LA-NPC (stage III and IVA, UICC eighth) diagnosed pathologically from June 2017 to November 2019 were randomized into CCRT with docetaxel plus cisplatin group (25 patients), CCRT with docetaxel group (50 patients), and CCRT with cisplatin group (50 patients). The incidence of grade 3 or 4 acute toxicities and clinical efficacy were analyzed among the 3 groups. Results: Safety evaluation was completed in all the 125 patients, during the CCRT period, 66.4% of patients completed 3 cycles of chemotherapy, 24.0% completed 2 cycles of chemotherapy, and 9.6% completed 1 cycle of chemotherapy according to the research plan. The incidence of grade 3 or 4 acute toxicity in CCRT with docetaxel plus cisplatin (DP), docetaxel (D), and cisplatin (P) groups was 88.0%, 72.0%, and 56.0%, respectively. The incidence of grade 3 or 4 acute toxicities in the DP group was significantly higher than that in the D and P groups (P = .015), no significant difference was detected between the D and P groups (P = .096). The most common toxicities were mucositis (40.0%), leukopenia (29.6%), neutropenia (26.4%), and pharyngo-esophagitis (12.0%); compared to D and P groups, DP group did not significantly improved the 3-year overall survival (96.0% vs 87.0% and 87.6%), progression-free survival (92.0% vs 79.7% and,76.9%), locoregional failure-free survival (96.0% vs 91.8% and 92.7%), and distant failure-free survival (100% vs 90.0% and 89.0%), there were no significant difference in survival data among the 3 groups (all P > .05). Conclusions: Higher survival benefits did not achieve from intensified CCRT with DP, CCRT with P or D obtained similar short-term survival outcomes with similar acceptable toxicities in LA-NPC patients.
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Affiliation(s)
- Yanrong Luo
- Medical School of Chinese PLA, Beijing, China.,Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China.,Department of Radiation Oncology, Hainan Hospital of Chinese PLA General Hospital, Sanya, China
| | - Boning Cai
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Bo Li
- Department of Cardiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, China
| | - Fang Liu
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lei Du
- Department of Radiation Oncology, Hainan Hospital of Chinese PLA General Hospital, Sanya, China
| | - Dawei Zhao
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China.,Department of Radiology, Pingjin Hospital, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China
| | - Wenjun Fan
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China.,Armed Police Forces Corps Hospital of Henan Province, Zhengzhou, China
| | - Linlin Meng
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xinxin Zhang
- Department of Otolaryngology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lin Ma
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China
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